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Swollen left leg with atrial anuersym - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Bones, Muscles and Joints
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3164 Questions
User :   Hi, I am a 50 yr. old female who doesn't smoke, and not overweight. I weigh 124lbs. and am 5ft. 6. I have mvp, svt, and an atrial anuersym in the atrial septal. I aslo have pvc's and pac's. I have been on ternormin for 29yrs. for svt. I have a yearly echo done for my mvp. I don't have a lot of broken veins in my legs that you can see. I have two or three little spider veins. I have one leg that swells more than the other one. I have small slender legs and little ankles. The left leg swells in the lower part below the knee and on and around the ankle. It looks bigger than the other one. Whenever I go to the dr. they always have you answer questions, and one of the questions is always, do you have swelling of the feet and legs. I always put yes, but the dr. never ever mentions it. I have told them several times, but they just seem to ignore my response. Whenever I go, it usually isnt swelled bad because my appt. is usually when I first get up and when I first get up, it isnt swelled. I goes down over night. I was wondering if you could help me as to what to do. No one else in my family has this problem. My sister is bigger than me and older and her legs never swell and my moms doesn't either. I worked in retail for 17years standing and they would ache and swell when I was working. Now I am not working and not standing hardly any at all and the left one is swelling. That concerns me, because I know it is not normal. What can I do?
Doctor :   hi
User :   hi
Doctor :   Dr. XXXXXXXX here. Let me read what you have typed.
User :   ok
User :   It is puffy also around the left knee, more right below the knee cap. And the calf area is swollen.
Doctor :   ok
Doctor :   are there any other medications that you take aprt from Tenormin?
User :   yes
User :   celexa 10mg, clonazepam 1mg, but I only take half of this one at bedtime and ambien
Doctor :   ok
Doctor :   have you had your recent kidney functions tested?
User :   I had a urine test in the drs. office
Doctor :   no, I mean to ask were these tests done for you in the recent times after you started getting the ankle swelling? the tests include Blood urea nitrogen, Serum creatinine, C-reactive protien, microalbuminuria, 24 hour urine protien, Liver function tests, and an abdominal ultrasound?
User :   a long time ago they collected it I think for 24 hrs and I had to keep it in the refrigerator
Doctor :   have you got this symptom discussed with a vascular surgeon?
User :   over ten yrs ago
User :   there are none where I live and never been suggested to me
Doctor :   i would suggest you to get these above mentioned tests done, after discussing with your treating physician the possibility of any effects on the kidney
Doctor :   to see if the swelling in leg is happening due to any of these tests being abnormal
User :   are there any other tests that would show what this might would be and why only one leg
Doctor :   and also it would suggest if the medications that you are currently on, are giving you any problems
Doctor :   if the problem is bothering you with only one leg, then there could be possibility of venous insufficiency that leads to swelling in dependent positions
Doctor :   keep yot ankle at your hip level while you are in sitting position
Doctor :   and see if this is still ocurring
User :   If it is the venous insufficiency, what could be the cause and tratment
User :   treatment
Doctor :   if it does occur even with your leg elevated, then it will most probably not be due to venous insufficiency and would need further investigations
User :   if all of these tests are negative, then what other ones should I have done
Doctor :   we cannot say for sure that these will be negative, since you have got symptoms
Doctor :   so get these done and see what the results show
Doctor :   then further course of action and treatment can be planned out
User :   my drs here dont care
User :   could you suggest what other tests might be the next course of action
Doctor :   you need to dicuss with them in detail your symptoms
Doctor :   or take second opinion from other doctors
Doctor :   or specialists around your place
User :   I have no specialist where I live
User :   small town
User :   that is why I am asking you so maybe I might can suggest them to the dr. to get the tests done
User :   I have been dealing with this for years and years
Doctor :   you can get to the closest town near your place then to find one there who you help
User :   I just want to know what is causing it
User :   you mean a specialist
Doctor :   unless it is examined in detail and further evaluation is done, the cause cannot be made out
User :   I have been to numerous drs, and none of them seem to care
Doctor :   so you need to consult a specialist there who can examine what the problem is and confirm with further investigations.
User :   they just push on my leg with my blue jeans on and say looks fine to me and that is it
Doctor :   such that appropriate treatment measures can be started soon
User :   I have been to heart dr. and family dr. and surgeons hers
Doctor :   you need to discus s with them at that time teh possible causes of why you are getting early moring pedal edema
User :   here
Doctor :   and if there are any chances taht kidney would be involved
User :   what is early morning pedal edema
Doctor :   or if there are chances that there could be venous insufficiency that could be causing swelling in only one leg
User :   it isnt swelled when I first get up
Doctor :   and what are the possibilities to look for the cause
User :   more toward the middle of the day and night for sure
Doctor :   and if not, then ask them to refer to a specialist in the nearest city
User :   what type of specialist
User :   venous specialist or kidney
User :   ?
Doctor :   it would either be a cardiologist, a vascular surgeon or a nephrologist, and it can be decided only after a detailed physical examination, which specialist they should refer you to.
User :   my heart dr. doesnt seemed concerned
User :   I have already told him about it
User :   it is never swelled when I am there so he isn't concerned
Doctor :   since I am not examining you personally, I would not be able to suggest you what is exactly wrong with you. You have to discuss with your treating doctors in your place about the problems you are facing and that you would like them to refer you
Doctor :   if they are not able to solve your problem
Doctor :   you have to explain to them when and how it gets swollen
Doctor :   then they would be able to understand what is happening
User :   ok, thank you for your help and information
Doctor :   or take an appointment in evening when the swelling is present such that they can examine it.
User :   ok, I will do that
User :   thanks again and have a good night!
Doctor :   wish you the same.
User :   thanks
Doctor :   thanks for consulting me. bye for now
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